Hostname: page-component-77f85d65b8-zzw9c Total loading time: 0 Render date: 2026-03-28T23:51:48.047Z Has data issue: false hasContentIssue false
  • English
  • Français

Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis: diagnostic criteria

Published online by Cambridge University Press:  13 August 2013

N Uri ,
O Ronen ,
T Marshak ,
O Parpara ,
M Nashashibi  and
M Gruber
N Uri
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
O Ronen
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
T Marshak
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
O Parpara
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
M Nashashibi
Affiliation:
Department of Pathology, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
M Gruber*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Lady Davis Carmel Medical Center, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
*
Address for correspondence: Dr Maayan Gruber, Department of Otolaryngolgy – Head and Neck Surgery, Lady Davis Carmel Medical Center, 7 Michal St, Haifa 34362, Israel E-mail: maayan_gr@yahoo.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Chronic sinusitis is one of the most common otolaryngological diagnoses. Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis can easily be misdiagnosed and treated as chronic sinusitis, causing continuing harm.

Aim:

To better identify and characterise these two subgroups of patients, who may suffer from a systemic disease requiring multidisciplinary treatment and prolonged follow up.

Methods:

A retrospective, longitudinal study of all patients diagnosed with allergic fungal sinusitis or eosinophilic mucin rhinosinusitis within one otolaryngology department over a 15-year period.

Results:

Thirty-four patients were identified, 26 with eosinophilic mucin rhinosinusitis and 8 with allergic fungal sinusitis. Orbital involvement at diagnosis was commoner in allergic fungal sinusitis patients (50 per cent) than eosinophilic mucin rhinosinusitis patients (7.7 per cent; p < 0.05). Asthma was diagnosed in 73 per cent of eosinophilic mucin rhinosinusitis patients and 37 per cent of allergic fungal sinusitis patients.

Conclusion:

Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis have the same clinical presentation but different clinical courses. The role of fungus and the ability to confirm its presence are still problematic issues, and additional studies are required.

Keywords

SinusitisFungusEosinophilMucinDiagnosis

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 9 , September 2013 , pp. 867 - 871
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1Lucas, JW, Schiller, JS, Benson, V. Summary health statistics for U.S. adults: National Health Interview Survey, 2001. Vital Health Stat 10 2004;218:1–134Google Scholar
2Ponikau, JU, Sherris, DA, Kern, EB, Homburger, HA, Frigas, E, Gaffey, TA et al. The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc Sep 1999;74:877–84Google Scholar
3Corey, JP. Allergic fungal sinusitis. Otolaryngol Clin North Am 1992;25:225–30Google Scholar
4Millar, J, Lamb, D. Allergic bronchopulmonary aspergillosis of the maxillary sinuses. Thorax 1981;36:710Google Scholar
5Bent, JP 3rd, Kuhn, FA. Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg 1994;111:580–8Google Scholar
6Katzenstein, AL, Sale, SR, Greenberger, PA. Pathologic findings in allergic aspergillus sinusitis. A newly recognized form of sinusitis. Am J Surg Pathol 1983;7:439–43Google Scholar
7Schubert, MS. Allergic fungal sinusitis: pathophysiology, diagnosis and management. Med Mycol 2009;47:324–30Google Scholar
8Manning, SC, Holman, M. Further evidence for allergic pathophysiology in allergic fungal sinusitis. Laryngoscope 1998;108:1485–96Google Scholar
9Loury, MC, Leopold, DA, Schaefer, SD. Allergic aspergillus sinusitis. Arch Otolaryngol Head Neck Surg 1993;119:1042–3Google Scholar
10Cody, DT 2nd, Neel, HB 3rd, Ferreiro, JA, Roberts, GD. Allergic fungal sinusitis: the Mayo Clinic experience. Laryngoscope 1994;104:1074–9Google Scholar
11Kupferberg, SB, Bent, JP. Allergic fungal sinusitis in the pediatric population. Arch Otolaryngol Head Neck Surg 1996;122:1381–4Google Scholar
12de Shazo, RD, O'Brien, M, Chapin, K, Soto-Aguilar, M, Swain, R, Lyons, M et al. Criteria for the diagnosis of sinus mycetoma. J Allergy Clin Immunol 1997;99:475–85Google Scholar
13Wise, SK, Rogers, GA, Ghegan, MD, Harvey, RJ, Delgaudio, JM, Schlosser, RJ. Radiologic staging system for allergic fungal rhinosinusitis (AFRS). Otolaryngol Head Neck Surg 2009;140:735–40Google Scholar
14Schubert, MS, Goetz, DW. Evaluation and treatment of allergic fungal sinusitis. I. Demographics and diagnosis. J Allergy Clin Immunol 1998;102:387–94Google Scholar
15Rupa, V, Jacob, M, Mathews, MS, Seshadri, M. A prospective, randomised, placebo-controlled trial of postoperative oral steroid in allergic fungal sinusitis. Eur Arch Otorhinolaryngol 2010;267:233–8Google Scholar
16Katzenstein, AL, Sale, SR, Greenberger, PA. Allergic aspergillus sinusitis: a newly recognized form of sinusitis. J Allergy Clin Immunol 1983;72:89–93Google Scholar
17Ferguson, BJ. Eosinophilic mucin rhinosinusitis: a distinct clinicopathological entity. Laryngoscope 2000;110:799–813Google Scholar
18Sacks, PL, Harvey, RJ, Rimmer, J, Gallagher, RM, Sacks, R. Topical and systemic antifungal therapy for the symptomatic treatment of chronic rhinosinusitis. Cochrane Database Syst Rev 2011;(8):CD008263Google Scholar
19Orlandi, RR, Thibeault, SL, Ferguson, BJ. Microarray analysis of allergic fungal sinusitis and eosinophilic mucin rhinosinusitis. Otolaryngol Head Neck Surg 2007;136:707–13Google Scholar